Prior Authorization Specialist Toxin at Dayton Center For Neurological Disorders Inc – Centerville, Ohio

The Botulinum Authorization Coordinator is responsible for obtaining all prior authorizations for all botulinum toxin procedures, verifying patient insurances for all botulinum toxin procedures, discussing patients’ financial responsibility for injections, and keeping an open line of communication with the other botulinum toxin staff (Medical Assistants, Providers, and Managers). Periodically meet with botulinum toxin representatives to keep abreast of updates and changes with regard to the different medications, insurance criteria, authorization issues, specialty pharmacy issues, available savings program, and reimbursement policies.

Responsibilities for this position include but are not limited to answering a multi-line call queue, Monitoring and performing authorizations for all botulinum toxin patients which entails monthly reports, eligibility checks, update code requirements, update insurance information, checks for mistakes and updates authorizations as needed. Submits authorization requests for new and recheck patients. Documents detailed cases of the authorization process for each patient, contacting patients’ insurance if authorization is ineligible, errored or as needed, verifying scheduling accuracy and appropriate notes are placed, scheduling consults appropriately based on diagnosis, scheduling recheck appointments as needed, confirming all botulinum toxin appointments with patients, assisting botulinum toxin clinical team as needed for administrative duties, monthly patient ordering for botulinum toxin which includes the following: running reports on patient appointments, sending correspondence to patients via patient portal, creating patient cases regarding deliveries, initiating deliveries as needed with pharmacies, patient reminder for deliveries/consent for and setting deliveries and determining total patient count for scheduling templates with the scheduling supervisor (or operations manager) as needed, iniating new start start orders by calling insurance to start authorization, calling pharmacy to start delivery process, educating patient on process and saving cards.